Fracture table



1941- E. E. LOBIGFELLOW FRACTURE TABLE 3 Sheets-Shet 1 Filed July 2,1938 Feb. 25, 1941 E. LONGFELLOW FRACTURE TABLE Filed July 2, 1938 sSheets-Sheet 2 Q NW W N 1941; I E. E. LONGFELLOW 3 95 FRACTURE TABLEFiled July 2, 1938 3 Sheets-Sheet 3 fzz/v/ezozoz' ZZJfZ Elozgfi lawywuwm Patented Feb. 25, 1941 UNITED STATES;

PATENT OFFICE FRACTURE TABLE Application July 2, 1938, Serial No.217,230

9 Claims.

My. invention relates to surgical apparatus, and more particularly tofracture tables utilized in the reduction of fractures,

I An object of my invention is to provide a frac- 'ture table that isadjustable to meet varying conditions of use in applying tractive forceto and maintaining proper location of the fractured parts during theapplication of splints, bandages or casts, and which is so constructedand arranged that fluoroscopic, therapeutic and other apparatus may beeasily used therewith.

Another object of my invention is to provide a portable fracture tablethat is adapted to be 1nounted on conventional forms of hospital andexamining tables and carrying carts, and which includes means foradjustably supporting some of the parts thereof in positions beyond thelimits of the table or cart upon which it is;

mounted.

Another object of my invention is to provide a fracture tableparticularly adapted to maintain proper setting of the fractured boneduring formation; and hardening of a cast, the parts of which apparatusare constructed and arranged to minimize interference with the formationof the cast and so as to be separable from'the cast after it hashardened. 7

Another object of my invention is to provide fracture reducing apparatushaving fulcrumed traction bars and which provides lateral adjustment ofthe fulcrums for the traction bars to compensate for various lateralpelvic dimensions of different patients, so as to bring the fulcrums forthe traction bars substantially into alignment with the hip pivot axesof the patient.

Other objects, features and advantages of my invention will be apparentfrom the following .description and the drawings wherein a preferredembodiment of my invention is clearly shown and described.

In the drawings:

Fig. 1 is a perspective view of a fracture table embodying a preferredform of my invention;

Fig. 2 is a fragmentary sectional view taken substantially on the line2-2 of Fig. l and in the direction indicated by arrows;

Fig. 3' is a fragmentary view of a'portion of the fracture tableembodying a preferred form of the present invention and'has partsthereof shown in section, the section being taken substantially on theline 3--3 of Fig. 2 and in the direction of the arrows;

Fig. 4 is a fragmentary sectional view with the section takensubstantially'on the line 4-4 of 55. Fig. 3 and in the direction-of thearrows; and

Fig. 5 is a fragmentary sectional view with the section takensubstantially on the line 55 of Fig. 3 and in thedirection of thearrows.

With particular reference to the drawings, a central or main support Icomprisesa base plate 2, a flanged coupling 3 secured to the base plate2 by rivets or other suitable fastening means 4,

a coupling post 5 that is preferably threadedly connected at its ends tothe flanged coupling 3, v and a double-T coupler 6, as well as a flanged10 member I and a base support post 8 which are secured to the side ofthe double-T coupler 6 opposite the couplingpost 5. Clamps 9 and I0 areprovided for securing the main or central support I toany ordinary orconventional type 15 of hospital or examining table or to a carryingcart.

The clamps 9 and. I0 each include a pair of strips II and I2, I3 and I4,respectively, which strips areslidably connected to the base plate 2 20by rivets such as I5 or other suitable means, which are secured to thebase plate 2 and extend through slot such as IS in the strips H, [2, i3and I4. The strips ll, l2, l3 and 14 have upwardly extending endportions l1, l8, l9 and 20, 25 respectively, which support clamps 2| and22 that extend longitudinally of the strips and are provided fordetermining the adjustment of the strips, The clamps include threadedrods 23 and 24 which extend through the portions I1 30 and I 9'01 thestrips l l and i 3, respectively, and telescopically engage tubularmembers 25 and 26, which tubular members are secured at their ends tothe portions l8 and 20 of the strips l2 and l'4,'re'spectively, by bolts21 and 28 or other 35 suitable means.

- Manually operable set screws 29 and 30 are threaded into the walls ofthe tubular members 25 and 26, respectively, and are adapted to engagethe threaded rods 23 and 24 to secure the 40 positions of the rods withrespect to the tubular members and accomplish quick rough adjustment ofthe clamps 9 and I0. Thumb nuts 3| and 32 are threaded onto the rods 23and 24 on the outside of the portions l1 and I9 of the strips 45 II andI3 to accomplish the final adjustment of the clamps 9 and Ill.Downwardly extending portions 33, 34, 35 and 36 on the strips H, l2, l3and 14, respectively, engage the sides of a table 31. A pad 38 of feltor some suitable ma- 5 terial is provided to prevent the base plate 2from marring the top of the table 31.

As most clearly shown in Fig. 2, laterally extending arms 39 and 40 arethreaded into opposite sides of the double-T coupler 6, so that they aresubstantially oppositely disposed perpendicular to the axis of the basesupport post 8. The arm 39 has openings therein such as 4| that arespaced at different distances from the basesupport post 8, and the arm48 has openings therein such as 42 which are also spaced at differentdistances from the base support post 8. The openings 4| are provided toaccommodate a screw 43, ,or. other suitable means, upon which a tractionbar 44 is fulcrumed through a coupling unit 45, which is threaded ontothe end of the traction bar 44 and has a portion 46 of reduced sectionthrough which the screw 43 extends. The openings 42 are adapted toaccommodate a screw or other suitable means 41 to fulcrum a traction bar48 through a coupling unit 49, which isthreaded onto the traction bar 48and has a portion 50 of reduced section through which the screw 41extends. p

The oppositely extending arms 39 and 46 are preferably substantiallyperpendicular to a median line between the traction bars 44 and 48,

so that movement of the fulcrum for either of the traction bars 44 or 48by changing the opening through which one of the screws 43 or 41 extendsvaries the lateral distance between the traction bars 44 and 48 at theirfulcrums. Wing nuts 5| and 52 are preferably threaded onto the screws 43and 41, respectively, on the side of the arms 39 and 46 opposite thetraction bar coupling units 45 and 49. The fulcrum supports for thetraction bars 44 and 48 which are provided by the arms 39 and 4|] andthe screws 43 and 41 support an end of each of the traction bars so hatthe other ends of the bars may be swung laterally to a desired position.

Auxiliary supports 53 and 54 are slidably mounted on the traction bars44 and 48, respectively, and have feet 55 and 56 which are roatable withrespect to the traction bars and slidable in a channel track 51. Thechannel track 51 extends transversely across the top of the table 31 andpreferably extends beyond the limits of the top of the table,particularly if the table is narrow, to support the traction bars 44 and48 in positions such as that indicated by dot and dash lines at 44a forthe traction bar 44 in which the auxiliary supports are outside thelimits of the table top. This feature makes possible a wider range ofmovement of the traction bars on a narrow table without having theauxiliary supports too close to the fulcrums for the traction bars. Theengagement of the feet 55 and 56 by the side walls of the channel track51 also provides an additional factor of stability of support andprevents the feet from slipping off of the track. Furthermore, since theauxiliary supports 53 and 54 are slidable on the traction bars, and thefeet 55 and 56 are rotatable with respect to the traction bars, thetrack is movable to a wide variety of positions on the table and tovarious angles with respect to the traction bars, so that the ends ofthe track are easily kept out of the way of any accompanying apparatusand the surgeon or attending personnel.

Extensible struts 58 and 59 are fulcrumed to the main or central supportby a screw or other suitable means 69, which extends through theopenings 6| and 62 in the struts 58 and 59, respectively, and through anopening 63 in a coupling unit 64 that is secured to the double-T coupler6 intermediate the traction bars 44 and 48. The struts 58 and 59 arealso fulcrumed to the traction bars 44 and, respectively, through clamps65 and 66 which engage the respective traction bars and have screws suchas 61 extending therethrough and through the struts 58 and 59. The strut58 preferably includes telescopically engaged members 98 and 69, and thestrut 59 preferably includes telescopically engaged members 10 and 1|.The longitudinal extension of the telescopically engaged parts of thestruts 58 and 59 is fixed or locked by a clamp including a wing nut suchas 12, so that when the traction bars are swung about their respectivefulcrums to .a predetermined position, the positions of those bars maybe fixed by locking the struts 58 and 59 at that position of therespective traction bar.

Leg supports 13 and 14 are adjustably secured to the traction bars 44and 48, respectively. Since the structure of the leg supports 13 and 14is similar, like reference numerals apply to similar parts of the twosupports.

In these leg supports 13 and 14, cradles 15 have standards securedthereto for supporting the cradles which preferably comprise a pair ofstrips 16 and 11. The strips 16 and 11 are fulcrumed to clamps 18 andpreferably have wing bolts 19 for clamping the strips 16 and 11 in anadjusted angular position with respect to the clamps 18. The clamps 18are adjustable longitudinally and angularly with respect to the tractionbars by loosening a clamping bolt 89 while the adjustments are made. Thecradles preferably have pads 8| of felt or other suitable materialsecured to the leg supporting surfaces thereof.

Footpiece support brackets 82 and 83 are adjustably secured to thetraction bars 44 and 48. Since the structure of the footpiece supportbrackets 82 and 83 and their cooperating footpieces are similar, likereference numerals will be applied to the similar parts of each.

Vertical supports 84 have clamping portions 85 which preferably includecooperating parts engaging the traction bars and connected to them byhinges such as 86. The clamping portions 85 are secured in position withrespect to the traction bars by bolts such as 81 and cooperating wingnuts 88. Tubular clamps 89 eX- tend through openings in the verticalsupports 84 and are secured in position by set screws or other suitablefastening means 99. Rotation of the tubular clamps 89 is prevented by aflattened surface 9| which engages a flat surface in the openingsthrough the vertical supports. The tubular clamps 89 have a partiallysplit side and wings 92 adjacent the split portion and providingopenings through which clamping screws 93 extend. Wing nuts 94 cooperatewith the clamping screws 93 to effect a clamping action. Sub--stantially T-shaped members 95 have threaded stems 96 which extendthrough the tubular clamps 89, sothat the stems 96 are disposed insubstantially parallel relation with respect to the traction bars 44 and48. The inner surfaces of the split portions of the tubular clamps 89are preferably threaded to engage the threads on the stems 96 when thewing nuts 94 are tightened. Upon loosening the wing nuts 94, the stems96 are preferably slidable longitudinally within the clamps 89 forapplying tractive force to a patients limb and effecting a roughlongitudinal adjustment of the T-shaped members 95. The stems 96 arealso preferably rotatable within the clamps 89 when the wing nuts 94 areloosened to provide a rotatable adjustment of 5 tudinal adjustment ofthe T-shaped members 95.

Cross bar portions 98 of the T-shaped members 95 have a pair of spacedand substantially parallel openings through which legs of invertedsubstantially U-shaped members 99 extend. The

10 U-shaped members 99 are slidably adjustable with respect to the crossbars 98 and are secured in position by wing bolts I which are threadedinto the ends of the cross bars. Ties or links IOI have substantiallyparallel openings there- 15 through through which the other legs of theU-shaped members extend. These ties or links IOI are slidable withrespect to the U-shaped members and are secured in position by wingbolts I02. The substantially U-shaped members 099 and the ties or linksIOI comprises footpieces which are vertically adjustable with respect tothe footpiece support brackets 82 and 83.

A pelvic support I03 has a tubular portion I04 that fitsover the basesupport post 8. The tubu- 25lar portion I04 is notched at I05 to engagethe flanged member 1 to prevent turning of the pelvic support withrespect to the base support post 8. An upper support post I 06 isthreaded into the base support post 8 at one end and has an extensionpost I01 secured to the other end thereof by a coupling I 08. A perinealsupport I09 is slidably mounted on the upper support post I06. Thepelvic support I03 and the perineal support I09 are cooperativelynotched at II 0 to prevent 35' the perineal support from turning withrespect to the pelvic support. To provide greater comfort to thepatient, the perineal support has a longitudinally extending opening atIII, the edges of which opening are smooth and rounded 40 to preventchafing or discomfort.

Sling supports I I2 and I I3 are secured to bearings H4 and H5,respectively, which are slidably fitted to the extension post I01. Thesling supports H2 and H3 extend outwardly substantially 4,; at rightangles to the extension post I01 and are slidably adjustablelongitudinally of the extension post I01, as well as rotatable about theextension post I01 to a desired angular position with respect to thetraction bars 44 and 48. The

50 sling supports H2 and H3 are held in a desired position by tighteningwing bolts IIS and H1 that are threaded into the bearings H4 and H5,respectively, and engagetthe extension post I01.

A back and head support I I8 includes a back 55 rest plate H9 and a headrest plate I20 that are adjustably secured together. Pads I2I and I22 offelt or other suitable material are secured to,

the surfaces of the back rest plate H9 and head rest plate I20,respectively. Since the base plate 60 pad and clamps for securing theback and head 70 gether as at I24 and fulcrumed to a hinge plate I25 asat I26; the hinge plate I25 being secured to the base plate 2. The linksI23 and fulcrums I24 and I26 are so constructed and arranged that theheight of the back support plate I I9 and 75 head support plate I20 isadjusted by turning a bolt I21; the construction and arrangement alsobeing such that substantially parallel relation is maintained betweenthe top of the table 31 and the back support plate I I9 and head supportplate I20.

In the use of the fracture table disclosed, the upper support post I06and perineal support I09 are removed to increase the ease of placing thepatient upon the table and are replaced to the I positions illustratedafter the patient has been placed upon the table. The patient is firstso placed that the pelvic support supports the patients pelvis; the legsupports support the patients legs, and the back and head supportsuports the patients back and head at a height determined by theadjustment thereof. The fulcrums for. the traction bars 44 and 48 arethen adjusted to substantial alignment with the patients hip joints bymovement of the screws 43 and 41, most clearly shown in Fig. 2, to theopenings M and 42, respectively, which most nearly effect suchalignment. The patients feet are secured in desired angular and verticalpositions by bandaging the feet to the U-shaped members 99 and adjustingthe vertical and angular positions of those members. It is to be notedthat by utilizing the U-shaped members 99 as foot supports, the verticalposition to which the feet can be adjusted can be varied through a widerange without interference from the footpiece support brackets 82 and03. Also, by wrapping or extending the binding, which secures the feetin place, around both legs of the U-shaped members, the resilience ofthose members aids in I02 and withdrawing the U-shaped members up--wardly. The desired angular positions of the patients legs are securedby swinging the traction bars about gheir respective fulcrums andsecuring the traction bars in their proper angular position bytightening the. wing nuts such as 12 on the struts 58 and 59. If it isdesirable to support one or both of the patients legs in slings, thoseslings may be supported by the sling supports H2 and H3 and those slingsupports may be adjusted to the proper angular and vertical position.

While I have illustrated and described these specific embodiments of myinvention, I contemplate that many changes may be made thereover withoutdeparting from the scope or spirit of my invention.

I claim: p I

1. In portable fracture reducing apparatus adapted to be mounted on andclamped to a table, the combination comprising a main support adapted tobe mounted on the table, traction bars fulcrumed to the main support, amovable channel track adapted to be supported solely by the table andproviding a continuous trackway from end to end, and auxiliary tractionbar supports movable longitudinally of the traction bars, said auxiliarytraction bar supports having feet rotatable with respect to the tractionbars and guided by the channel, and said track being slidable on thetable lengthwise of and angularly with respect to said traction bars andhaving a length such that said auxiliary traction bar supports may besupported thereon beyond the sides of the table.

2. In portable fracture reducing apparatus adapted to be secured to atable, the combination comprising a main support, means for securing themain support on a table, traction bars fulcrumed to the main support, amovable track adapted to be supported by the table, said track beingslidable on the table lengthwise of and angularly With respect to thetraction bars, and auxiliary traction bar supports having feet supportedby and movable relative tothe track, whereby the track may be placedinvarious positions both angularly and lengthwise with respect to thetable for given placements of the traction bars.

3. In portable fracture reducing apparatus adapted to be secured to atable, the combination comprising a main support having means securingit in position on the table, a pelvic support 'secured to the mainsupport, traction bars fulcrumed to the main support, a track transverseto the table and extending beyond the sides of the table, extensiblestruts fulcrumed at their ends to the main support between the tractionbars and adjustably secured at their other ends to the traction bars andauxiliary traction bar supports having base portions slidable on thetrack and guided thereby, said track being adapted to support thetraction bars beyond the sides of the table.

4. In fracture reducing apparatus, the combination comprising, asupport, a traction bar fulcrumed at one end to the support, a straighttrack transverse to the traction bar and movable to various angularpositions with respect to the traction bar for all angular positions ofthe latter, and an auxiliary traction bar support movable longitudinallyof the traction bar, said support having a foot rotatable with respectto the traction bar, and said foot being slidably supported and guidedby said track.

5. In fracture reducing apparatus, the combination comprising, tractionbars and cooperating adjustable parts for each of the bars comprehendinga foot piece support bracket secured to the bar and longitudinallyadjustable with respect thereto, said bracket including a memberrotatable with respect to the rest of the bracket and adjustable in aline substantially parallel to the bar, said member having a pair ofparallel openings therein, a pair of resilient substantially U-shapedfoot pieces slidably mounted in said openings and having substantiallyparallel legs, and means for holding the U-shaped foot pieces in a fixedposition with respect to said member.

6. In fracture'reducing apparatus, the combination comprising a mainsupport, a traction bar fulcrumed at one end to the main support, a footpiece support bracket secured to the traction bar and movablelongitudinally thereof, said bracket including a rotatable andlongitudinally adjustable member extending substantially parallel to thetraction bar and means for clamping said member to prevent rotation andlongitudinal movement thereof, a pair of resilient substantiallyU-shaped foot pieces each having one leg adjustably secured to saidmember and the other leg disposed between the bracket and the fulcrumedend of the bar, said legs extending transversely with respect to thetraction bar and a cross bar adjustably mounted on and connecting saidlastmentioned legs of said U-shaped foot pieces, whereby a foot supportis formed.

'7. In fracture reducing apparatus, the combination comprising a mainsupport, a traction bar secured to the main support, foot piece supportmeans rotatable and longitudinally adjustable with respect to thetraction .bar, means supporting said foot piece supporting means mountedon and at a fixed distance from said traction bar, means for securingthe position of said foot-piece supporting means with respect to thetraction bar, and a pair of resilient U-shaped foot pieces each having apair of legs of substantially equal length, one of which. legs issupported by said foot piece support means and adjustable toward andaway from the traction bar and the other of which legs is disposedintermediate the foot piece support means and the main support, and across bar adjustably mounted on and connecting the intermediate legs ofsaid pair of U-shaped foot pieces, whereby a foot support is formed.

8. Fracture reducing apparatus comprising, in combination, a mainsupport, an adjustable back support, a pelvic support secured to themain support, a perineal support removably secured to the main supportadjacent the pelvic support, oppositely disposed laterally extendingarms secured to the main support below the pelvic support, a pair oftraction bars each having one end fulcrumed to and supported by one ofthe arms, the fulcrum being movable longitudinally of the arms, a singletrack movably disposed with respect to the traction bars, auxiliarysupports for the traction bars mounted for longitudinal movement on saidbars and slidable on the track and guided thereby, and foot supportsadjustably secured to the traction bars, said foot supports eachincluding a pair of adjustably mounted substantially U-shaped footpieces having substantially parallel sides.

9. In fracture reducing apparatus, the combination including, a mainsupport, a traction bar secured to the main support, a supporting memberextending transversely of said traction bar, a foot piece provided witha threaded portion, and means adjustably mounting said foot piece onsaid member, said last-mentioned means including a clamping member onsaid member releasable to permit angular and longitudinal movement ofthe foot piece, and rotatable threaded means associated with saidclamping member and threaded portion of said foot piece for effectinglongitudinal movement of the foot piece when the clamping means istightened to a predetermined degree.

EARL E. LONGFELLOW.

